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Lisa Mayo, RDH, BSDH
Staci Janous, RDH, BS
POLISHING, FLOSS, FLUORIDE,
INSTRUMENT SHARPENING
DH101: PRECLINICAL SCIENCES
CONCORDE CAREER COLLEGE
Wilkins CH 27: ToothbrushingWilkins CH 28: Interdental Care and IrrigationWilkins CH 29: Dentifrice & mouthrinsesWilkins CH 35: FluoridesWilkins CH 38: Instruments and principles for
instrumentation
Nield CH 22: Concepts for instrument sharpeningNield CH 23: Instrument sharpening techniquesNield CH 28: Cosmetic polishing procedures
REFERENCES
1. Polishing2. Floss3. Toothbrushing4. Toothpaste5. Fluoride6. Adjunct Aids7. Oral Hygiene Instruction
OUTLINE
OBJECTIVE #1: POLISHINGNIELD CH28
Cosmetic procedure to help remove extrinsic stains from teeth
Thorough brushing/flossing can produce the same eff ects as polishing
Can scratch tooth surfaces: esp cementum/dentinDoes NOT improve the uptake of fluorideSome patients like and others do not
POLISHING
Aerosol production and splatter Do not use on patients with known communicable
conditions (TB) Do not use on patients with respiratory conditions or
immunocompromisedCreation of bacteremia (bacteria in the bloodstream)
Need to make sure premed was taken prior to polishing
Iatrogenic damage to tooth surface CEJ is thin and can be abraded by polishing agents Polishing creates heat is not done properly (primary
teeth w/large pulp chamber) Could injure gingiva
POLISHINGADVERSE EFFECTS
1. Lack of stain2. Sensitive teeth (can use sensitive polish paste)3. Do not polish exposed cementum or dentin
(recession)4. Restored tooth surfaces (scratching, eroding, pitting
can occur)5. Newly erupted teeth (mineralization is occurring)6. Implant abutments7. Areas of demineralization (soft tooth structure)8. Gingiva
POLISHINGCONTRAINDICATIONS
Selective polishing: polishing only those areas with an objectionable appearance
Current theories: remove as much stain as possible with hand or power driven devises fi rst before polishing
The most common technique for stain removal is with RUBBER CUP POLISHING/POWER DRIVEN POLISHING
POLISHING
Components1. Handpiece (handle)
Slow speed handpiece Attaches to dental unit
2. Prophy angles (shank) Can be right-angled (straight shank) or contra-
angled (bent shank) Many companies manufacture Can be reusable or disposable (our clinic uses,
most common)3. Prophy cup attachments (more on another slide)
POLISHING
POLISHING
POLISHINGCORDS AND HANDPIECE
Poor Ergonomics
POLISHING
POLISHING
Latch Design Threaded Head Button-Ended Head
3. Prophy Cup AttachmentsNatural or synthetic rubbers: non-latex which are very soft and flexible
Internal cup design: wide range, effect cleaning ability and amt prophy paste delivered to the tooth
Length and diameter: vary (short or standard)Flexibility: soft and firmBristle brush attachments
Ortho appliancesPits and grooves of teethCareful not to injure gingiva
POLISHING
POLISHING
Abrasive AgentSubstances that remove extrinsic stains by scratching and abrading the tooth surface
Differing particle sizes/grit: larger the size = deeper scratches
Manufacturers label as extra fine, fine, medium, coarse, extra coarse
Use the smallest grit particle size to achieve your goals
POLISHINGMINIMIZING TOOTH LOSS
Rubber Cup AdaptationParallel to tooth surface being polishedWhen angle = ↑ scratching
Pressure: use just enough pressure to make the cup flare slightly
Speed of Application: SLOWEST speed as possible so as NOT to overheat tooth
Application Time: 1-2sec per tooth
POLISHINGMINIMIZING TOOTH LOSS
POLISHING
POLISHING
TOO MUCH PXPASTE!!
POLISHING
1. Before Polishing Discuss importance daily plaque control/removal Remove as much stain as possible with
instruments2. Patient Preparation
Review patient medical history for contraindications
Explain the rationale for selective polishing Obtain informed consent Make sure eyewear is in place
3. Clinician Preparation PPE Low or High Speed Suction
POLISHING PROCEDURE
4. Supine patient position5. Latex-free cup with correct grit paste6. Establish correct fulcrum7. Rest handpiece in V-Shape area of your hand
between index finger and thumb8. Hold cord between 4 th & 5 th finger9. Hold cup away from tooth & activate foot pedal so
speed is slow and steady10. Start UR Facial most posterior tooth and polish each
tooth until end at the UL Facial most posterior tooth11. Apply just enough pressure to make rim of cup flare
slightly12. Use a wiping-motion on the crowns of the teeth
covering the entire facial surface and flaring the cup into the interproximal
POLISHING PROCEDURES
13. Refi ll prophy cup with paste every 3-4 teeth. An empty cup will not polish the teeth and only create excessive heat. Be sure to remove saliva from the cup on a dry gauze before placing cup back into the mouth.
14. Once upper facials are completed, the clinician will polish upper linguals #16-1
15. Rinse the upper arch thoroughly16. Drop down to mandibular arch and polish in the
same sequence (#32-17F then #17-32L)17. Rinse after mandibular arch completed
POLISHING PROCEDURE
Hard for patient if you do NOT rinse until completed both arches of polishing (a lot of prophy paste in their mouths they may swallow)
Many prophy pastes DO contain fluoride (read labels carefully)
Many ingredients in prophy paste: some patients may have allergies to them (ex: Yellow dye #5)
Some patient do NOT like px paste: off er alternatives (no polishing, let them brush their own teeth, air polishing)
Use any sequence you like as long as it is the same for every patient so you do NOT miss areas (for now while you are learning, use the sequence presented today)
POLISHINGKEY POINTS
Point Value: 1 0
1. Uses sufficient paste
2. Applies paste to 2 - 3 teeth at a time
3. Uses a secure fulcrum and fulcrum finger as pivot
4. Uses the proper speed (as slow as possible)
5. Uses the proper grasp on the handpiece
6. Cover all surfaces
7. Rinses or suctions paste as needed by patient
8. Operator position is correct
9. Adjusts light as necessary
10. Operator uses mirror correctly
*11. Utilizes proper infection control protocol
TOTAL POINTS:
POLISHING COMPETENCY
OBJECTIVE #2: FLOSS
Recommended prior to brushing: fluoride from toothpaste can reach interproximally
12-15in length of flossWrap floss around middle fingerUse thumb and index finger of each hand for guidingGrasp fi rmly with only ½in of loss between fingertips
FLOSSWILKINS P.412
Rotate floss to use a new section often Use a GENTLE, slow, sawing motion to guide floss
past each contact areaControl floss to avoid floss-cuts in gingival tissuesCurve the floss around each tooth and slide up-
and-down with firm pressure making a “C-shape” with the floss Floss should be inserted under the gingival
tissues until reaching a “stopping point” (about 1-2mm deep)
FLOSSWILKINS P.412-413
Copyright © 2010 by Saunders, an imprint of Elsevier Inc.
30
Indicated for use proximal surfacesAids in minimizing decay interproximallyMaterials
1. Silk: Not used anymore, 1st developed 2. Nylon. Nylon multifilaments
Waxed or Unwaxed Circular (floss) or flat (tape)
3. Expanded PFTE: Plastic monofilament polytetrafluoroethylene with wax
Types of floss Research has shown no difference in the
effectiveness of waxed or unwaxed floss for biofilm removal
Biofilm removal depends on how floss is applied
DENTAL FLOSSWILKINS P.411
Waxed / PFTE Helps prevent trauma to tissues Slides through contact area with ease Resists breakage or shredding when passed over
irregular tooth or root surface (overhang fillings, calculus, etc…)
Unwaxed Thinner Pressure against a tooth surface spreads the
nylon fibers and gives a wider surface for biofilm removal
Be careful not to floss cut oneself!! Can fray when rubbed over an irregular tooth/root
surface
DENTAL FLOSSWILKINS P.411
Enhancements1. Color 2. Flavors (mint, cinnamon most common)3. Therapeutic agents: fluoride, whitening
Limited research as to their effectiveness
DENTAL FLOSS
REVIEW
Floss is made of the following materials except:
A) silkB) waxed nylonC) unwaxed nylonD) expanded PTFEE) wood filaments
ANSWER
E) Wood filaments is the correct answer.Floss is made from silk, waxed and
unwaxed nylon, and expanded PTFE.
FLOSSING COMPETENCY
Point Value: 1 0 1. Uses approximately 12 - 15 inches of floss 2. Wraps floss around middle fingers 3. Establishes and maintains a fulcrum (one in the anterior, two in the posterior)
4. Uses index finger as a guide 5. Inserts floss at an angle to the tooth 6. Passes floss through the contact area with “see-saw” motion
7. Controls floss to prevent “snapping” 8. Maintains short length ¾ “ to 1” between index fingers 9. Presses floss against teeth 10. Creates and maintains a “C” formation 11. Slides under the gums with an “up-and-down” motion 12. Avoids injury to the interdental papillae 13. Continually wraps / unwraps to use the clean portion of the floss
14. Utilizes correct dental lighting positioning *15. Utilizes proper infection control protocol Total Points:
OBJECTIVE #3: TOOTHBRUSHINGWILKINS CH27
The most commonly used device for removing oral biofilm
Well designed to remove oral biofilm from the facial, lingual, and occlusal tooth surfaces
Patients NEED toothbrushing instructionsToothbrush Filament Design
Filaments: # & arrangement varyMost filaments are 10 -12 mm long
TOOTHBRUSHING
CHARACTERISTICS OF AN EFFECTIVE MANUAL BRUSH
Conforms to patient requirementsEasily manipulatedReadily cleanedEnd-rounded filamentsProperties
Flexibility, softness, strength, lightness of handle
REVIEW
Which one of the following characteristics would be least desirable in a toothbrush?
a. Conforms to individual patient in size, shape, and texture
b. Readily cleaned and aerated, impervious to moisture
c. Bristle or filament height 21 mmd. End-rounded filamentse. Durable and inexpensive
ANSWER
C) Bristle or filament height 21 mm is the correct answer.
The filament height is usually 11 mm, not 21 mm. Filament height is not one of the characteristics of an effective toothbrush, either.
Copyright © 2010 by Saunders, an imprint of Elsevier Inc.
42
43Copyright © 2010 by Saunders, an imprint of Elsevier Inc.
Typically activated by electricity or batterySuitable for almost any clientEffective in controlling stainPatients need power toothbrushing
instructions
POWER TOOTHBRUSH
2 minutes is often the recommended amount of time
Average brushing time is <30seconds
Patients usually think their brushing time is more than double the actual time
Recession & AbfractionAbrasive / Too Hard Brushing Incorrect technique (scrubbing back-and-forth)
TOOTHBRUSH POINTS
Copyright © 2010 by Saunders, an imprint of Elsevier Inc.
46
SEE HANDOUT FOR DIFFERENT METHODS & WILKINS P.393
RollBass SulcularModified BassStillmanModified StillmanFones(circular)Horizontal (scrub)Leonard (Vertical)Occlusal
TOOTHBRUSH TECHNIQUE
Copyright © 2010 by Saunders, an imprint of Elsevier Inc.
48
BASS OR
STILLMAN
Copyright © 2010 by Saunders, an imprint of Elsevier Inc.
49
CHARTERS
50
ROLL
Copyright © 2010 by Saunders, an imprint of Elsevier Inc.
51
FONES
HORIZONTAL/SCRUB
OCCLUSAL BRUSHING
QUESTION
If your patient was a child with limited dexterity what method of brushing would you recommend?
ANSWER
Roll or FonesFones 1st technique for kids prior to dexterity development
Roll: good as a technique prior to being able to use sulcular
QUESTION
What method of brushing is recommended for a 12 year old patient in full orthodontics?
ANSWER
ChartersFilaments 45 degree angle toward occlusal
Enough pressure to force filaments between teeth
Vibrate back and for 10sec 2-3x/teethHeel/toe for anterior lingual’s
BRUSHING TECHNIQUE
Light, comfortable grasp Control brush at all times Grasp handle in the palm of the hand with thumb
against the shank, near the head of the brush so that it can be controlled effectively
Position filaments in the proper direction for placement on the teeth (depends on the brushing method using)
Apply appropriate pressure: Too much pressure bends the filaments and curves them away from the area where brushing is needed
WHICH ONE DOES YOUR TOOTHBRUSH LOOK LIKE?
CARE OF TOOTHBRUSHES
Brush replacement: 2-3 monthsMore often for immunosuppressed personsDispose anytime after an illness or infection or surgery
Rinse thoroughly after each useBrush storage
Open air with head in upright positionClose container encourage bacterial growth
OBJECTIVE #4: TOOTHPASTEWILKINS CH29
↓ Caries ↓ Biofilm formation ↓ Gingivitis↓ Supragingivial calculus↓ Tooth sensitivityRemove stains
DENTIFRICES
1. Abrasives 20-40%2. Humectants 20-40%3. Water 20-40%4. Detergents 1-2%5. Binders 1-2%6. Sweeteners 1-2%7. Coloring Agents as needed8. Flavoring as needed9. Preservatives 2-3%
TOOTHPASTE COMPONENTSWILKINS P.425
TOOTHPASTE COMPONENTS
Abrasives (20-40%)Clean and polishPhysically remove biofilm and stainCalcium carbonate, phosphate salts, hydrated aluminum oxide, silica’s
TOOTHPASTE COMPONENTS
Humectants (20-40%)Retain moisturePrevent hardening when exposed to airStabilize preparationXylitol, glycerol, sorbitol
Detergents (1-2%)Loosen debrisSurfactant (↓ surface tension)Foaming and emulsify debrisSodium lauryl sulfate
TOOTHPASTE COMPONENTS
Binders (1-2%) Stabilize Mineral colloids, natural gums, seaweed,
celluloseColoring agents
Attractiveness but may cause mucosal rxns Vegetable dyes, tartrazine
TOOTHPASTE COMPONENTS
Sweeteners/Flavoring Agents Create a favorable taste Xylitol, glycerine, manitol, sorbitol, saccharine,
essential oilsPreservatives (2-3%)
Prevent bacteria growth Prolong shelf lifeAlcohol, benzoates, phenols
SPECIALTY TOOTHPASTE
WhiteningHydrogen peroxide Carbamide peroxide
Tooth sensitivity: occlude dentinal tubulesPotassium nitrate/citrate/chloride
Gingivitis reductionStannous FluorideTriclosanZinc citrate Sodium Monofluorophosphate
SPECIALTY TOOTHPASTE
Calculus reductionTetrapotassium pyrophosphateTetrasodium hexametaphosphate (ex: Crest Pro Health)
Zinc chlorideZinc citrateTriclosan (ex: Colgate)
In a dentifrice, what is the function of the humectant?
A) Prevents separation of ingredientsB) Prolongs a product’s shelf lifeC) Maintains the consistency of the product
D) Retains moisture
REVIEW
D) Retains moisture is the correct answer.
The purpose of the humectant is to retain moisture. The binder prevents separation and maintains consistency and the preservative prolongs shelf life.
ANSWER
Fluoride
OBJECTIVE #5
Fluoride & Tooth DevelopmentFluoride & The BodyFluoride Toxicity & Lethal DosesFluoride Delivery
1.Community Water2.In-Office3.At-Home OTC and Rx
FLUORIDE OUTLINE
FLUORIDE & TOOTH DEVELOPMENT
WILKINS P.428 & CH35MOSBY’S DENTAL HYGIENE BOARD
REVIEW
Fluoride is a nutrient essential to the formation of sound teeth and bones
Pre-Eruptive: Mineralization stageFluoride is deposited during the formation of the enamel
Fluoride is incorporated directly into the structure during mineralization
Results in the development of shallower occlusal grooves and fissures
FLUORIDE & TOOTH DEVELOPMENT
Post-EruptiveUptake is most rapid on the enamel surface during the first years after tooth eruption
Continuing intake of drinking water with fluoride provides a topical source as it washes over the teeth
Fluoride in enamelUptake: depends on amt fluoride in oral environment and length of time of exposure to fluoride
Natural constituent of enamelOuter surface has highest concentrations
FLUORIDE & TOOTH DEVELOPMENTWILKINS P.518-520
FLUORIDE ABSORPTION IN BODYWILKINS P.518
Begins in stomach as hydrogen fluoride (HF)Rate depends on solubility of F compound & gastric activity
↓ when taken with milk/foodWhatever not absorbed by
stomach goes to small intestineMax blood levels reached in
30min after intake
FLUORIDE DISTRIBUTION IN BODYWILKINS P.518
Strong affi nity for calcified tissues – 99% located in mineralized tissues
Highest concentration in surfaces closest to the source supplying F (ie: tooth surface)
Stored in crystal lattice of teeth and bonesAmount stored varies w/intake amt, exposure
time, age/stage of developmentDentin fluoride concentrations < enamel
FLUORIDE EXCRETION IN BODYWILKINS P.518
Kidneys by urineSmall amts in sweat and fecesLimited transfer via breast milk
FLUORIDE TOXICITY & LETHAL DOSEWILKINS P.536
Toxic Dose Induce emesis F ion will bind to MILK or LIME JUICE Call 911
Safe Dose Adult: 1.25-2.5G Child: 0.5G
Lethal Dose F 32-64mg of PURE fluoride per Kg body weight Adult: 5-10G Child: 0.5-1.0G
Amt F Ingested
Emergency Tx
≤5mg/kg 1. Admin fluoride-binding agent
≥5mg/kg 1. Induce vomiting (emesis)2. Admin fluoride-binding agent3. Seek medical tx
≥15mg/kg 1. Seek medical tx2. Induce vomiting3. Cardiac monitoring
FLUORIDE: TOXICITYWILKINS P.536
Symptoms being within 30min – 24hrsGI: hydrochloric acid acts on F ion to form
hydrofluoric acid – irritates stomach lining Nausea, vomit, diarrhea, abdominal pain,
increase salivation, thirstSystemic Involvement
Symptoms of hypocalcaemia (low calcium levels in blood)
Convulsions, paresthesia Cardiac failure, respiratory paralysis, death
Treatment Induce vomiting (emesis) Administer F-binding agents
FLUORIDE: TOXICITYWILKINS P.536
Skeletal fluorosisResults after long-term use of water with 10-25ppm for industrial exposure
Dental fluorosisWhen excess F is in drinking water during the years of tooth developmentBirth until 12-16yrs
FLUORIDE THERAPYCOMMUNITY WATERWILKINS P.522-523
SystemicFluoridation: adjustment of F ion content in water supply to the optimum physiologic concentration that will provide:
1965: 1st communities fluoridatedAvg cost: $0.13 - $5.48 per person/yearMost cost effective way to bring F to a community!!
FLUORIDE THERAPYCOMMUNITY WATERWILKINS P.522-523
Community FluoridationLevels range 0.7-1.2ppm mg/LEPA monitorsCompounds used:
1. Sodium fluoride2. Sodium silicofluoride3. Hydrofluosilic acid
FLUORIDE THERAPYCOMMUNITY WATERWILKINS P.522-523
Community Fluoridation Most effective in reducing caries smooth surface Least effective in reducing caries pit and fissures Anterior teeth have better protection then
posterior due to above reason
FLUORIDE THERAPYCOMMUNITY WATERWILKINS P.522-523
Community Fluoridation Disadv.
1. Have to drink community water Reasons why not universal
1. Controversial effects of systemic F2. Public not informed of benefits of F3. Powerful Lobbyist's
Prevention of dental caries Id special problems: areas adjacent to
restorations, orthodontic appliances, xerostomiaDesensitization of recession
Fluoride aids in blocking dentinal tubulesPatient and/or parent education
Help patients understand the benefits & limitations of topical fluoride
FLUORIDE DELIVERYIN-OFFICE
WILKINS P.527
IN-OFFICE FLUORIDEWILKINS P.528
Fluoride Percent Notations
NaF (neutral sodium fluoride) 2% Gel or foam
NaF (neutral sodium fluoride) 5% Varnish
APF (acidulated phosphate fluoride)
1.23% Gel or foamNot for colored restorations
SnF (Stannous fluoride) 0.8% Unpleasant tasteStains teethGingival sloughingDiscolor restorations
IN-OFFICE FLUORIDETECHNIQUE
WILKINS P.529-530Tray technique: Gel or foam
Covers all exposed root surfacesFollow manufacturer recommendations for length of time (ADA ONLY supports 4min)
Post-Op: No rinse, eat, drink, brush, or floss 30 min after tray
Varnish technique (5% NaF)Premeasured wells w/ applicator brush Post-Op
Avoid hot drinks, alcoholic beveragesNo brushing or flossing teeth 4 -6 hours
Point Value: 1 0
1. Selects proper tray size
2. Use proper amount of fluoride foam
3. Patient in upright position
4. Dries teeth
5. Inserts trays properly
6. Inserts saliva ejector in between trays and positions for patient comfort. Has patient hold suction.
7. Instructs patient to tilt head forward slightly
8. Stays with patient throughout procedure
9. Times procedure for 1min
10. Removes trays and saliva ejector correctly
11. Has patient inset saliva ejector for final suction
12. Gives proper post-op instructions
*13. Utilizes proper infection control protocol
TOTAL POINTS:
FLUORIDE COMPETENCYTRAY ONLY, NOT VARNISH THIS
TERM
Who? Xerostomia, Root surface hypersensitivity, Rampant caries
Dentifrices that are brushed on 2-3x/day OTC or Rx Stannous fluoride Neutral Sodium Sodium Monofluorophosphate
FLUORIDE FOR HOME USEWILKINS P.523
At-Home Rx Fl in Trays
1.1%NaF (5,000ppm) Safe for restorations
1.1%APF (5,000ppm) Not safe for restorations
0.4%SnF (1,000ppm) Can stain teeth
Low potency/high frequency (OTC)High potency/low frequency (Rx)Not for use <6yrs
FLUORIDE MOUTHRINSEWILKINS P.533
Mouthrinse Rx Frequency
Rx or OTC
0.2% NaF (905ppm) 1x/week Rx
0.044% NaF/APF (200ppm) 1x/day OTC
0.05% NaF (230ppm) 1x/day OTC
0.0221%NaF (100ppm) 2x/day OTC
REVIEW
Which of the following systemic fluoride delivery methods would be considered most economical?
A) Dietary fluoride supplementsB) Naturally occurring in foodsC) Community water fluoridationD) Professional fluoride treatment
ANSWER
C) Community water fluoridation is the correct answer.
Community fluoridation is the most economical systemic method for caries prevention available. Dietary supplements and foods that contain fluoride are sources of systemic fluoride, but are not as economical. Professional applications are not considered systemic.
OBJECTIVE #6: ADJUNCT AIDSWILKINS CH28
WILL COVER IN MORE DEPTH IN CLINIC II
Toothbrushing does not reach the interproximal surfaces
Who may need:1. Increased risk for or who have periodontal
disease 2. Orthodontics3. Large embrasure spaces4. Arthritis (inability to floss correctly)
ADJUNCT AIDS
ADJUNCT AIDS
Disclosing agentsFloss (braided, unbraided, waxed, unwaxed, or tape)Floss holderFloss threaderTufted floss, yarn, gauzeEnd Tuft Interdental proxy brush/aidsWooden/plastic/triangular wedges/sticksToothpicks, perio aid, rubber tipTongue cleanersPower brushOral Irrigation/Water JetDenture brush
ADJUNCT AIDSCOMPETENCY
Point Value: 1 0
1. Disclosing agent
2. Fones method of brushing
3. Leonard method of brushing
4. Stillman method of brushing
5. Modified Stillman method of brushing
6. Charters method of brushing
7. Bass method of brushing
8. Modified Bass method of brushing
9. Roll method of brushing
10. Interdental brush
11. End tuft brush
12. Toothpick holder
13. Wedge stimulators
14. Rubber tip stimulator
15. Floss holder
16. Floss threader
17. Tongue cleaners
TOTAL POINTS:
ORAL IRRIGATION
Effective method of delivery for Chemotherapeutic agents
Disrupts loosely adherent microbial colonization
Point tip perpendicular to long axis of tooth
Copyright © 2010 by Saunders, an imprint of Elsevier Inc.
106
DENTURE BRUSH
END-TUFT BRUSH
INTERDENTAL/PROXY BRUSH
WOODEN/PLASTIC PICKS
FLOSS HOLDER/PICKERS
RUBBER TIP STIMULATORS
TONGUE CLEANERS
POWER BRUSH
OBJECTIVE #7: OHIWILL COVER IN MORE DEPTH CLINIC
II
Explain what you will be discussing with patientHave patient demonstrate how they brush/floss
fi rstMake suggestions and teach correct way to
brush/flossThen you demonstrate how to brush/floss
correctlyAllow patient time to practice and demoSuggest adjunctive aids as indicatedEncouraging and motivationalSpeaks at patient’s levelGives instructions written down if needed
ORAL HYGIENE INSTRUCTIONS
Disclosing solution to help identify areas of plaque & calculus supragingivally!
Good to do prior to OHIWe use in clinic and record on Plaque-Index O’Leary’s
FormSelective dye in solution that stains materia alba,
plaque, soft debris, pellicle (will learn next week)
OHI
OHI: PLAQUE INDEX
CLINICAL ASSESSMENT OF ORAL BIOFILM
The presence of oral biofi lm is most commonly assessed by passing a dental explorer over the tooth surface
Disclosing agents are used to make oral biofi lm clinically visible1. FLUORESCEIN DYE (FD&C Yellow No.8)
Visible under UV light More expensive but will leave no visible stain behind
2. Two-tone dyes (FD&C Red No.3 & Green No.3) Combo solution Can differentiate old rom new biofilm Discloses plaque but not gingival tissues
DISCLOSING SOLUTION
Will stain decalcified and pitted tooth surfaces
Use Vaseline on lips and restorationsAvoid using prior to sealant application
THE END